A new paper published in the New England Journal of Medicine outlines the challenges Americans are facing in winning the battle against the nation’s obesity epidemic—mainly their own denial.

The paper, entitled “Are Americans Ready to Solve the Weight of the Nation?” comes via the Institute of Medicine, and finds that the nation’s obesity epidemic is a result of many complex factors from habits forged at home and school, influences from work and media to the food system itself. Even environmental factors play a role—pesticides and other chemicals that disrupt the body’s hormonal systems making weight gain and diet-related illnesses including type 2 diabetes unexpected side effects are rampant in our culture.

Despite polls that put the blame mostly on parents for childhood obesity, the report author Colleen Barry, an associate professor at Johns Hopkins Bloomberg School of Public Health, says the issue is much more complex. Barry told Fox News, “Even for parents and individuals that are most dedicated to trying to address weight problems, the deck is stacked against them.”

An historically contentious issue, recent moves to tackle obesity like New York City Mayor Michael Bloomberg’s proposed ban on large-sized sodas are often so overshadowed by the politics that the issue itself gets lost in the rhetoric. Barry says that in order for meaningful changes to occur in our fight against obesity, we need better communication strategies to help us understand the many influences that lead to obesity.

More than one-third of the nation’s adults are clinically obese and 1 in 5 children are obese, according to the Centers for Disease Control.